A new technique to define and clarify esophageal motor disorders.
Ambulatory 24-hour esophageal manometry was applied to analyze motility in 12 normal subjects and 9 patients with chest pain and dysphagia caused by diffuse esophageal spasm (DES). Pain episodes characterized by nonperistaltic activity occurred in 7 of 9 patients. A score based on 10 variables of the motility pattern differentiated patients from normal subjects and quantitated the severity of the disorder. Ambulatory motility monitoring was prospectively performed in 8 normal subjects and 37 patients: 8 with DES, 13 with hypertensive contractions, and 16 with a nonspecific disorder on standard manometry. The score was positive in 6 of 8 patients with DES and negative in all normal subjects (accuracy 87 percent). Nine of the 13 patients with hypertensive contractions (70 percent) and 6 of 16 with nonspecific disorders (38 percent) had a pathologic score reflecting a dysmotility as severe as DES. Ambulatory esophageal manometry is a more physiologic way to identify a motor disorder than standard manometry and has the potential to improve selection of patients for a surgical myotomy.
Eypasch
E P
EP
Department of Surgery, Creighton University School of Medicine, Omaha, Nebraska 68131.
Stein
H J
HJ
DeMeester
T R
TR
Johansson
K E
KE
Barlow
A P
AP
Schneider
G T
GT
D000328:Adult; D000368:Aged; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000503:physiopathology; D015155:Esophageal Spasm, Diffuse / Q000175:diagnosis / Q000503:physiopathology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010528:Peristalsis